MEDICARE: DR. DAVID BRUCE JENKINS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	28458	CA

General Provider Information

NPI Number	:	1225078819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID BRUCE JENKINS D.D.S.

Provider Business Mailing Address
First Line	:	161 THUNDER DR
Second Line	:	SUITE 208
City	:	VISTA
State	:	CA
Zip	:	92083-6052
Country	:	US
Telephone Number	:	760-758-8506
Fax Number	:	760-758-5775

Provider Business Practice Location Address
First Line	:	161 THUNDER DR
Second Line	:	SUITE 208
City	:	VISTA
State	:	CA
Zip	:	92083-6052
Country	:	US
Telephone Number	:	760-758-8506
Fax Number	:	760-758-5775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	01/04/2026

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